August 19, 2014 | by Denise Heady
Christine Crews isn't only a fitness enthusiast, she's also a personal trainer and fitness instructor. Being active defines her life. So when she was diagnosed with bladder cancer at age 30, she decided she absolutely couldn't let the disease interfere with that lifestyle.
And it didn’t. For the next 15 years, Crews continued to run marathons, teach fitness classes and train 20 to 30 clients a week, all while fighting her bladder cancer with chemotherapy and periodic tumor removals.
By the age of 45, however, the cancer had spread to 80 percent of her bladder. She was told she would need a cystectomy, that is, the surgical removal of her bladder.
Her doctor recommended that Crews make an appointment at a major cancer center to determine what procedures were possible. She visited a couple of centers near her home in Memphis, Tennessee, but was not satisfied with any of their options.
She wanted a minimally invasive robotic cystectomy that would allow her to quickly recover, as well as an unobtrusive urinary diversion, a surgically created path through which urine leaves the body. She needed both in order for her to quickly resume, and then keep, her precystecomy lifestyle.
Her neighbor’s husband, a urologist, listened to her needs and understood. He referred her to City of Hope, on the other side of the country from her home. At City of Hope, she met surgeon Kevin Chan, M.D., associate clinical professor in the Division of Urology and Urologic Oncology.
Chan gave Crews an option no one else gave her: minimally invasive robotic surgery, with a less invasive diversion called the Indiana pouch continent urinary reservoir, or the Indiana pouch.
In this procedure, the surgeon creates an internal reservoir (pouch) for urine collection using the large intestine and a portion of the small intestine. Then he or she connects a piece of the small intestine to the outside of the skin and uses this as a small stoma, or opening. The surgeon then creates a one-way valve mechanism so that urine is kept inside the internal pouch and will not leak out onto the skin.
To empty the pouch, the patient inserts a small catheter into the stoma a few times a day. Perhaps best of all for an active fitness instructor, the stoma is easily hidden with a Band-Aid.
“Dr. Chan was very open to what I wanted,” Crews said in a recent interview about her decision to seek care at City of Hope. “I didn’t want the stoma to be at my belly button. I wanted it to be below my bikini line so I can still wear a bikini. Everything I said I wanted out of the surgery, he did it.”
Just a little over a month after the surgery, Crews was back at the gym teaching fitness classes and settling back into her presurgery life. Only the people she tells about her stoma know of its existence; no one else can detect any physical difference between Crews and any other fitness instructor.
“If it wasn’t for Dr. Chan and City of Hope, I don’t know where I would be,” Crews said. “I just feel very fortunate and blessed.”
Crews often shares her experience with clients and friends to educate them about the importance of being active. She knows one of the reasons she was able to have the Indiana pouch as an option and recover so quickly was because of her healthy lifestyle.
“There’s going to be something that will happen to you in your life," Crews said. “But if you’re healthy and you stay active, then you’ll be able to get through it a lot easier and have better options.”
Better options also come with expert care.
Related: Other doctors told bladder cancer patient Sheldon Querido that he would need to have his bladder removed and wear an external collection bag. Instead, he came to City of Hope. Read Sheldon Querido's story.
Learn more about becoming a patient or getting a second opinion at City of Hope by visiting us online or by calling 800-826-HOPE (4673). City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.